Background:Urinary tract infections (UTIs) are common in children and can lead to significant morbidity. Rapid and accurate diagnosis is essential for timely treatment and reducing complications. This study evaluates the predictive validity of urine dipstick tests for nitrites and leukocyte esterase (LE) in diagnosing UTIs compared to urine culture.Methods:A prospective study was conducted at the Department of Pediatrics, Southern Railway Headquarters Hospital, Chennai. A total of 186 children aged 3 to 12 years with suspected UTI were included. Urine samples were analyzed using dipstick tests for nitrites and LE, with urine culture as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated.Result:Nitrite test sensitivity was 82.19%, specificity 92.92%, PPV 88.24%, and NPV 88.98% (P < 0.001). LE test sensitivity was 87.67%, specificity 82.30%, PPV 76.19%, and NPV 91.18% (P < 0.001). Diagnostic accuracy for nitrites was 88.71% and for LE was 84.41%.Conclusion:Urine dipstick tests for nitrites and LE are reliable screening tools for UTIs in children, providing high specificity and reasonable sensitivity. They facilitate prompt treatment decisions, improving clinical outcomes.